Provider Demographics
NPI:1295818136
Name:DIONISIO, MARCY JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:MARCY
Middle Name:JAMES
Last Name:DIONISIO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7575 W BELL RD
Mailing Address - Street 2:SUITE# 101
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-4807
Mailing Address - Country:US
Mailing Address - Phone:623-412-7877
Mailing Address - Fax:623-979-8049
Practice Address - Street 1:7575 W BELL RD
Practice Address - Street 2:SUITE# 101
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-4807
Practice Address - Country:US
Practice Address - Phone:623-412-7877
Practice Address - Fax:623-979-8049
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDC4998111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0934240OtherBCBS OF AZ NON-PAR
AZAZ0934240OtherBCBS OF AZ NON-PAR